ABSTRACT
To set the stage for understanding the current dilemmas in our field, we will provide a brief overview of the history of American medicine. We will examine the development of psychiatry as a medical specialization in the context of that history and of psychoanalysis as a further specialization within psychiatry. The rise in prestige of medicine in America, of psychiatry within medicine, and of psychoanalysis within psychiatry were due to their perceived ability to offer treatment rather than care. As it became aligned with scientific progress and masculine authority, psychoanalysis came to contrast itself with psychotherapy, which it associated with palliative care and the feminine values of support and relationship. For our review of American medicine, we draw primarily from Rutkow’s (2010) Seeking the Cure to provide the background for understanding how psychoanalysis came to be positioned as a treatment that provided cure rather than care.
